Emerging molecular screening for breast cancer
Breast cancer is the most common cancer among women in the U.S., and the chance of a woman having invasive breast cancer some time during her life is a little less than one in eight. The American Cancer Society estimates about 207,090 new cases of invasive breast cancer in women and about 54,010 new cases of non-invasive carcinoma in situ in the U.S. in 2010. However, breast cancer death rates have been decreasing. This is probably the result of earlier cancer detection and better treatment.

The American College of Radiology (ACR), Society of Breast Imaging (SBI) and American Society of Breast Disease (ASBD) have launched the Mammography Saves Lives campaign to educate women about the importance of beginning an annual mammography routine at age 40.

However, a recent Norwegian study casted doubts on biannual mammograms for women between the ages of 50 and 69 years. The Norway-wide screening program of 40,075 women accounted for only one-third of the total 10 percent reduction in breast cancer deaths during a follow-up time of 8.9 years.

Molecular breast imaging can be useful in screening and detection of invasive breast cancer and ductal carcinoma in situ missed on mammography. Clinical studies, performed by Mayo Clinic researchers have shown that the sensitivity was 91 percent overall and 69 percent for tumors 5 mm or less using a dual-head molecular breast imaging system. Out of 650 high-risk patients who underwent breast cancer screening, molecular breast imaging detected seven cancers, five of which were missed on mammography. The sensitivity of molecular breast imaging was found to be 88 percent for invasive ductal carcinoma, 79 percent for invasive lobular carcinoma, and 89 percent for ductal carcinoma in situ (Am J Surg 2008;196(4):470-6).

In a recent case report published in the July issue of Journal of Surgical Radiology, molecular breast imaging was useful in the diagnosis of pseudoangiomatous stromal hyperplasia, a benign condition of the breast when mammography and ultrasound images showed no areas of concern. With new clinical studies on the way, molecular breast imaging is emerging as the possible first line screening tool for women with dense breast tissue.

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Manjula Puthenedam,